The Dr Louise Newson Podcast

128 - Making decisions about cancer treatment and the importance of quality of life with Steve Payne

In this episode, Dr Louise Newson is joined by a long-time friend, retired consultant urologist, Steve Payne. Together they discuss Steve and his wife Jan’s experience of her breast cancer and subsequent treatment that led to estrogen depletion. Steve describes the decision-making process they went through as a couple when Jan’s quality of life deteriorated due to severe urine and kidney infections, as well as other symptoms relating to a lack of estrogen.

The experts talk about how some people’s experience in cancer care clinics can fall short of patients and their partners being given full and balanced information into how cancer treatments will affect your hormones and what this potentially means for your quality of life. Steve shares his honest reflections and insights about cancer care clinics and offers invaluable advice for those navigating these complex and confusing decisions at such a difficult time.

Steve’s advice for making decisions about cancer treatments:

1. Ask what the benefits, and especially the downsides, of the treatment are. It is key that you understand all the pros and cons of a treatment being recommended to you.
2. If it’s treatment for cancer, ask about the pure cancer survival rates – once deaths from other causes have been removed from the data – to make sure you know the actual level of survival benefit that the suggested treatment offers.
3. If you’re having side effects from breast cancer treatment due to a lack of estrogen, have a discussion about the pros and cons of taking HRT, for your particular type of cancer. Ask how taking HRT could improve your daily life and wellbeing and what benefits HRT offers for bone and heart health in the future. Ask how would taking HRT affect your pure cancer survival rate.

Steve has written more about his and Jan’s experience and offers practical advice here, along with a new factsheet about making informed decisions during cancer care.

127 - Introducing Alistair Darby, CEO of Newson Health

In this episode, Dr Louise Newson explains about an exciting new appointment for Newson Health and introduces Alistair Darby as the new CEO. Coming from a hospitality background, Alistair explains what led him to apply for the role of CEO of a menopause healthcare company, and he shares how his awareness of menopause increased after he witnessed the devastating impact on his wife 5 years ago.

Alastair and Louise discuss the problem of the menopause in the workplace and the resulting gap of female talent at the top. They talk through their joint mission to normalise getting treatment for the perimenopause and menopause and speculate on what a difference this would make to relationships, the workplace, healthcare and society.

Through his role, Alistair hopes to:

1. Get men to wake up and smell the (menopause infused) coffee! This is a huge gender inequality issue.
2. Work together to scale up what we do and give more women access to treatment and HRT than is currently the case. This will have a transformative effect on many more lives.
3. Help women to feel fitter, and more energetic as they grow older, so they can continue to make an amazing contribution – for them, their families, society and the economy.

126 - What does the evidence say about breast cancer and HRT? With Professor Isaac Manyonda

Professor Isaac Manyonda is back by popular demand to discuss perhaps the most important issue for women considering and taking HRT; what is the risk of breast cancer if I take HRT? Professor Manyonda expertly takes the listeners through the different issues, one by one, including comparing the level of risks of breast cancer from HRT with lifestyle factors such as weight and alcohol intake. He outlines the risks according to different types of estrogen and progesterone, and explains the difference between estrogen receptor positive and negative breast cancers.

This episode is a must-listen for anyone who wants to be able understand – and clearly explain to others – the evidence-based picture around breast cancer and HRT, for both healthcare professionals and anyone interested in the topic.

Prof. Manyonda’s 3 take-home messages:

1. The strong evidence shows that estrogen does not increase the risk of breast cancer and it could even have a protective effect.
2. If you take estrogen and develop breast cancer you have a lower risk of dying from the cancer than women not taking estrogen.
3. The benefits of HRT extend way beyond the improvement of your symptoms and include protection of the cardiovascular system, your bone health, your immune system, and potentially prevention of dementia.

125 - ‘Yes, I’ve had breast cancer but now I need help with the menopause‘ with Dr Sarah Ball

Menopause specialist, Dr Sarah Ball, makes a record 4^th appearance on the Dr Louise Newson podcast this week, to talk about an important group of women that often feel marginalised when it comes to menopause care and treatment. One in seven women will experience breast cancer, and many more of us have a close relative who has had breast cancer. Thankfully, thousands more women are living longer after breast cancer, but this often means living with the menopause and symptoms of a lack of hormones.

The experts discuss the risk factors of developing breast cancer and the complexities of the association between hormones and breast cancer. Dr Sarah Ball has researched the experiences of menopausal women having breast cancer treatment and her findings reveal women are having to endure menopausal symptoms for an average of 7 years before seeking, or being given, help and treatment, and sadly, only 10% of the women surveyed felt they were involved in decisions about their care.

Dr Ball and Dr Newson are both passionate about helping women after breast cancer and believe it is essential that these women are listened to, that healthcare professionals discuss in full the treatment options for their menopausal symptoms, and that women feel empowered to make a decision that’s right for them, at that time, being aware of all the relevant information.

Sarah’s 3 tips for women after breast cancer:

1. Don’t feel guilty for how you feel about your menopause, you’re not complaining, or moaning or being ‘weak’. It’s really important that your symptoms are addressed. You are your whole body, not just your breasts. Don’t lose sight of the health of your heart, your bones, your skin, your sex life, your mental health and brainpower – these are important too.
2. Symptoms relating to your vagina, vulva and urinary function are treatable by using vaginal estrogen. This is safe to use after breast cancer and is not absorbed by the whole body in the same way as HRT. You can tackle these symptoms successfully, even if you feel you do not want to take HRT.
3. Understand you do have a choice. Guidelines recommend you should be listened to and have a say in decisions about treatments. Tell your healthcare professionals what is most important to you in terms of living your life, treating your menopausal symptoms, and managing the risk of cancer returning.

Follow Dr Sarah Ball on Instagram @drsarahmollyball and Twitter @sarahball14

Making decisions around your cancer treatment and menopause is often a complicated and overwhelming process. There is a new factsheet on balance website about making informed decisions about cancer treatments here, and a personal story written by the partner of a woman having worsening menopause symptoms after breast cancer treatment here.

124 - Menopause specialists advocating for women of colour with Dr Nneka Nwokolo and Dr Martina Toby

Dr Nneka Nwokolo and Dr Martina Toby are both consultant physicians in sexual health and HIV medicine, and together they have joined forces to help educate and advocate for women of colour experiencing perimenopause and menopause.

In this episode, the experts share what prompted them to set up the ‘Shades of Menopause’ Instagram group and the benefits of using social media to support women of colour. Together with Dr Louise Newson, they discuss some of the socioeconomic and cultural factors, as well as gender inequalities that affect a woman’s experience of healthcare, and the unfortunate lack of research around use of HRT in women of colour.

Nneka and Martina’s three tips to women of colour:

1. Do your own research and ask other women about their experience
2. See your GP for help. Ask who is the best person to see at your practice. Go equipped with knowledge already, and you will get a much better outcome.
3. You are not alone, millions of women like you are going through it. If you feel you can’t speak up, find a friend who is willing to do it for you. Your voice matters and needs to be heard.

Follow the podcast guests on Instagram @shadesofmenopause

123 - The Menopause Revolution with Carolyn Harris MP

Carolyn Harris MP left school at 16, had two children at a young age and worked as a barmaid. Her young son, Martin, was tragically killed in a road accident in 1989 and this changed her life forever. She sank into a black hole for the next few years but turned things around when at 34 she became the first person in her family to go to university. Carolyn never dreamt that 20 years later she would be the MP for her community, Swansea East, and although she continues to experience imposter syndrome regularly, once she has decided to fight for change, she does not give up.

Carolyn has campaigned on topics such as child funerals and gambling. She did not realise her collection of health problems were related to the menopause at first, but when she joined the dots and learnt more about the effects of the menopause, especially in the workplace, she set up an All Party Parliamentary Group on menopause and was successful in changing the law in Wales in removing the prescription fee for HRT.

 

Carolyn’s advice to women:

1. Be part of the menopause revolution. Find us on social media, there’s a template letter on the APPG website so you can write to your local MP, and contact my office or on Twitter if you’d like to get involved. Join us in London in Parliament Square for the Menopause Support Bill on the 29^th
2. Dreams can come true. Don’t think you can’t achieve something. You are brilliant and strong. You can be what you want to be, you just need to be brave.
3. We are using our platforms to call for change, but you can go into your place of work, talk about your own experience, ask others about theirs, say ‘do you think this could be the menopause?’

 

Carolyn Harris MP details:

Website: www.carolynharris.org.uk

Twitter  @carolynharris24 and @AppgMenopause

Email: carolyn.harris.mp@parliament.uk

122 - Myth-busting clots with Maggie Honey

Maggie Honey was diagnosed with antiphospholipid syndrome, which can be described as having ‘sticky’ blood that is prone to clotting. When she was 46 and a busy mum of triplets, Maggie began having insomnia, recurrent UTIs and dry eyes, skin and mouth. It wasn’t until her periods had stopped for a year and she felt dreadful all the time that she realised many of her symptoms might be related to menopause. When she sought help, she was given more diagnoses related to her blood condition but no help for her symptoms. Her blood disorder consultant at the time told her, ‘whatever you do, don’t go on HRT’. This was due to the inaccurate belief that all HRT holds a risk of clot.

In this episode, Dr Louise Newson talks through all the issues that Maggie’s story illustrates, including explaining why HRT is usually safe for people at risk of clot, when estrogen is given through the skin via a patch, gel or spray. They discuss how beneficial HRT can be for your quality of life, and what lifestyle factors do actually raise your risk of getting a clot.

Maggie’s 3 menopause tips for people at risk of clot:

1. Listen to your own body, keep a symptom diary like the one on balance app. Trust your own instincts and don’t be fobbed off.
2. Find a menopause specialist as well as a sympathetic blood specialist doctor (haematologist). Encourage communication between your different doctors, including your GP.
3. Share information with friends, family and colleagues. The more we talk about it, the more help we can give to one another.

Read more about Maggie’s story here and for more information, read our booklet on Menopause and Clots.

Thrombosis UK is the charity mentioned in this episode for people at risk of, or living with, thrombosis (clots) and the website is www.thrombosisuk.org

121 - Celebrating World Menopause Day: supporting one another

In this special episode, released on World Menopause Day 2021, Dr Louise Newson talks to two women about their own experiences of menopause. Melanie is a midwife from Birmingham who talks about her ongoing challenges of coping with menopausal symptoms, getting the right support at work, and finding a treatment that works for her. Grace is in her 50s and went through an early menopause in her late 30s. She struggled over the years to be listened to by healthcare professionals and have her needs understood as a gay woman. After watching the documentary with Davina McCall, Grace felt empowered to push for the help she knew she needed.

Melanie and Grace’s conversation with Louise aptly illustrates what World Menopause Day is all about – raising awareness about the effects of menopause on women’s health and wellbeing globally, and elevating voices of those going through the menopause from all cultural backgrounds and sexual orientation. As Louise says, we cannot fully celebrate World Menopause Day until all women, all over the world are able to get the help and support they need.

Grace and Melanie’s top reasons for speaking out for WMD:

1. Educating others about the effects of the menopause is so important.
2. Women need support and to know they are not alone – it’s not that something’s wrong with them.
3. Get ready for the menopause, it’s inevitable, embrace it, and be empowered to deal with it when the time comes.
4. Regardless of your colour, religion, or sexual orientation, come together and support one another.

120 - You are what you eat, with the Healthy Eating Doctor

Healthy Eating Doctor, Dr Harriet Holme, joins Dr Louise Newson on the podcast couch this week to discuss the importance of nutrition for reducing long term risk of disease and improving your future health.

Before becoming a registered nutritionist, Harriet worked for ten years as a doctor before her interest grew in the link between what we eat and our health. She is passionate about sharing evidence-based knowledge to help people understand more about their own diets and health, and offers nutritional consultancy as well as lecturing on culinary science and nutrition.

 

Harriet’s four key ingredients for eating in the peri/menopause:

1. Calcium is key, try and get it from your diet as much as possible.
2. Balance your diet with a wide variety of wholegrains (brown bread and brown pasta, for example) fermented food (such as kimchi or kefir), lots of fruit and vegetables, and avoid sweeteners and fizzy drinks.
3. Top up your omega 3 by eating 2 portions of oily fish a week.
4. And last but not least, vitamin D. Take this one as a supplement especially in autumn and winter in the UK. If you’re vegan, also take a B12 supplement, but otherwise it’s always best to get nutrients from your diet rather than relying on supplements.

 

Listen to Harriet on her own podcast, ‘Eating for Health’ or visit her website: healthyeatingdr.com

 

Find Harriet on social media at:

Facebook = @healthyeatingdrcom

Twitter = @healthyeatingdr

Instagram = @healtheatingdr

119 - Testosterone: why can’t we have our own hormone back? With Dr Zoe Hodson

Dr Zoe Hodson returns to the podcast this week to talk to Dr Louise Newson about the hormone testosterone. Zoe is a GP and senior doctor at Newson Health, and together they discuss the impact of low testosterone on your daily life, why it can be difficult to get hold of, and gender inequalities in healthcare provision when it comes to this particular hormone.

Zoe is on a personal mission to ask every local health commissioning group if their clinicians can prescribe testosterone and, if not, why not? Change is happening slowly within primary care and Zoe and Louise are committed to continue to push for testosterone to be regarded as an integral part of menopause care at a free, local level for all.

Zoe’s 3 asks for change:

1. We need to normalise testosterone in women, so please keep talking about it. If you take it already, tell people, and tell your healthcare professionals about the difference it makes to you.
2. Keep alerting your GP practice to the ‘Confidence in Menopause’ course on fourteenfish.com. It is now free for all healthcare professionals across the globe.
3. If you’re going to a menopause clinic and they haven’t mentioned testosterone, ask them about it.

Zoe would like to thank all her followers on social media for their wonderful support and encouragement to keep speaking up for women and trying to bring about change for good. You can follow Zoe on Instagram @manchestermenopausehive